Not only because the full board of PsychoseNet Belgium is co-author of the article, and I am too on behalf of PsychoseNet Netherlands, but above all because the study it describes touches the core of what we as a community have worked for over many years: making psychosis care more human, more focused on recovery and more connected. Science and expertise by experience go hand in hand in this study, and the result is thirteen action points that give a concrete framework for working in a way that supports recovery.
What is it about?
Twelve focus groups, 77 people, and nobody who asked for better diagnostics.
The article in Psychosis is about our Flemish study, with Stijn Vanheule and colleagues from Ghent, Leuven and Maastricht, the Flemish family platform, PsychoseNet and the psychiatric centre Gent-Sleidinge.
The context: Flanders has the highest number of psychiatric beds in Europe, 139 per 100,000 inhabitants. Recovery-oriented care is in every policy document. In daily practice little comes of it. So a simple question was put to four groups at once: people who are more than averagely psychosis susceptible, people close to them, nurses, and psychologists and psychiatrists. What has to be different tomorrow?
We expected clashing answers. They did not come.
Thirteen action points came out:
- A warm welcome, not an intake form.
- Dialogue in which the professional may also say that he does not know.
- Living together on a small scale: eating together, talking about music, walking outside.
- The story of the person at the centre.
- Continuity of relationships.
- Patience at the moment everyone is in a hurry.
- Listening to and working with the context of the person.
- Experts by experience as a structural part of the team, paid and equal.
- Organising care in consultation with the person and the people close to them.
- De-escalation in place of coercion.
- Containing the anxiety of professionals through supervision and a reflective team culture.
- Sharing responsibility, not enforcing the procedure.
- And finally, connection with the neighbourhood and with society.
Two statements by participants stayed with us
- A participant on the welcome: there is a difference between someone who comes to sit on the edge of your bed and someone who stands in front of you with papers.
- A psychiatrist on continuity: it is about handing over relationships, not information.
That is where the work is.
Time, closeness, continuity and room to deviate
What struck me most: not one group asked for sharper diagnostics, tighter protocols or more symptom reduction. They did ask for time, closeness, continuity and room to deviate when the situation calls for it. Nurses called that creative civil disobedience. Thirteen points that you can use tomorrow in training, in team reflection, in quality policy and in supervision frameworks. There is work to do.
The answer of practice to that simple question, what has to be different tomorrow? More human being, more relationship, more time and also more connection. A strikingly unanimous answer, with which we can do a lot.
Jim van Os
Source: Vanheule S, de Sloover M, Rabaey B, et al. What recovery-enabling services for psychosis should do: a multi-informant focus group study. Psychosis, 2026. doi.org/10.1080/17522439.2026.2679997
Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare.
Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.
Want to read more?
Blogs by Jim van Os can be read here
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